Provider Demographics
NPI:1467703447
Name:ALLEN, LADWANEE
Entity type:Individual
Prefix:
First Name:LADWANEE
Middle Name:
Last Name:ALLEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 NE WILSHIRE BLVD STE 206A
Mailing Address - Street 2:
Mailing Address - City:BURLESON
Mailing Address - State:TX
Mailing Address - Zip Code:76028-4117
Mailing Address - Country:US
Mailing Address - Phone:866-943-7779
Mailing Address - Fax:214-260-9888
Practice Address - Street 1:860 HEBRON PKWY STE 302
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75057-5143
Practice Address - Country:US
Practice Address - Phone:866-943-7779
Practice Address - Fax:214-260-9888
Is Sole Proprietor?:No
Enumeration Date:2012-10-01
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist